Analysis of Causes and Treatment of Facial Trauma in the Tulsa Metropolitan Area: A Level 2 Urban Trauma Center Experience

Background: Facial trauma remains a major public health issue, with causes that vary by region. National statistics often overlook local trends, which highlights the need for region-specific studies to create targeted prevention and treatment plans. Methods: This retrospective review included 801 patients with facial fractures at a Level 2 urban trauma center, which serves the Tulsa metropolitan area with a population exceeding 1,000,000 residents. Data from patient records and the trauma registry between 2021 and 2024 were analyzed for demographics, injury mechanisms, fracture details, Injury Severity Score (ISS), comorbidities, treatments, and geographic origin (Tulsa versus other areas). χ 2 tests examined categorical variables, while nonparametric tests evaluated continuous variables. Results: Most patients were male (73.8%) with an average age of 47.9 years. The main causes of injury were falls (23.4% overall; 51.0% in females versus 21.8% in males, P <0.001) and assaults (22.5% overall; 28.9% in males versus 13.8% in females, P <0.001). Firearm injuries were uncommon but more frequent among men (4.4% versus 0.5%, P <0.05). Falls made up 90.3% of injuries in patients over 85 years old ( P <0.001). Major trauma (ISS >15) was seen in 25.6% of cases. Orbital floor fractures (16.1%) were more common than Le Fort fractures (8.4%). Comorbidities included substance use disorder (17.1%) and mental or psychiatric illnesses (12.2%). Patients from Tulsa had lower median ISS (9 versus 11, P =0.005) but higher rates of assault (31.9% versus 20.3%) and firearm injuries (5.0% versus 2.3%; P <0.05). Conclusion: In this urban Midwestern population, falls were more common in females and older adults, while intentional violence was higher among males and Tulsa residents. These findings underscore the need for tailored interventions: fall prevention for older adults and women, violence screening for men, and integrated approaches to substance use and mental health treatment.